{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:23:53Z","timestamp":1780079033408,"version":"3.54.0"},"reference-count":21,"publisher":"Cambridge University Press (CUP)","issue":"S2","license":[{"start":{"date-parts":[[2012,6,28]],"date-time":"2012-06-28T00:00:00Z","timestamp":1340841600000},"content-version":"unspecified","delay-in-days":2280,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2006,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The potential for domestic or international terrorism involving cyanide has not diminished and in fact may have increased in recent years. This paper discusses cyanide as a terrorist weapon and the current state of readiness for a cyanide attack in the United States. Many of the factors that render cyanide appealing to terrorists are difficult to modify sufficiently to decrease the probability of a cyanide attack. For example, the relative ease with which cyanide can be used as a weapon without special training, its versatile means of delivery to intended victims, and to a large degree, its ready availability cannot be significantly modified through preparedness efforts. On the other hand, the impact of an attack can be mitigated through preparedness measures designed to minimize the physical, psychological, and social consequences of cyanide exposure. Although the nation remains ill-equipped to manage a cyanide disaster, significant progress is being realized in some aspects of preparedness. Hydroxocobalamin\u2014a cyanide antidote that may be appropriate for use in the prehospital setting for presumptive cases of cyanide poisoning\u2014currently is under development for potential introduction in the US. If it becomes available in the US, hydroxocobalamin could enhance the role of the prehospital emergency responder in providing care to victims of a cyanide disaster. Additional progress is required in the areas of ensuring local and regional availability of antidotal treatment and supportive interventions, educating emergency healthcare providers about cyanide poisoning and its management, and raising public awareness of the potential for a cyanide attack and how to respond.<\/jats:p>","DOI":"10.1017\/s1049023x00015910","type":"journal-article","created":{"date-parts":[[2016,8,24]],"date-time":"2016-08-24T03:49:28Z","timestamp":1472010568000},"page":"s56-s60","source":"Crossref","is-referenced-by-count":30,"title":["Terrorism Involving Cyanide: The Prospect of Improving Preparedness in the Prehospital Setting"],"prefix":"10.1017","volume":"21","author":[{"given":"Mark E.","family":"Keim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2012,6,28]]},"reference":[{"key":"S1049023X00015910_ref015","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199112193252508"},{"key":"S1049023X00015910_ref013","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199912000-00003"},{"key":"S1049023X00015910_ref011","unstructured":"11World Health Organization: Hydrogen cyanide and cyanides: human health aspects. Concise International Chemical Assessment Document 61. World Health Organization. Geneva, 2004."},{"key":"S1049023X00015910_ref008","first-page":"s40","article-title":"Acute cyanide poisoning in prehospital care: new challenges, new tools for intervention","volume":"2006l21","author":"Guidotti","journal-title":"Prehosp Disast Med"},{"key":"S1049023X00015910_ref012","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540180064034"},{"key":"S1049023X00015910_ref014","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X00001059"},{"key":"S1049023X00015910_ref010","unstructured":"10Agency for Toxic Substances and Disease Registry (ATSDR): Toxicological Profile for Cyanide (update). Public Health Service, US Department of Health and Human Services, Atlanta, GA. 1997."},{"key":"S1049023X00015910_ref004","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.68.12.1001"},{"key":"S1049023X00015910_ref006","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-200206000-00005"},{"key":"S1049023X00015910_ref021","article-title":"Hydroxocobalamin as a cyanide antidote in prehospital first responder care","volume":"29","author":"Hall","year":"2004","journal-title":"JEMS"},{"key":"S1049023X00015910_ref005","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.1.21"},{"key":"S1049023X00015910_ref020","first-page":"193","article-title":"Antidotal treatment of cyanide poisoning","volume":"66","author":"M\u00e9garbane","year":"2003","journal-title":"J Chin Med Assoc"},{"key":"S1049023X00015910_ref009","unstructured":"9 Baskin SI , Brewer TG : Cyanide Poisoning. Textbook of Military Medicine: Medical Aspects of Chemical and Biological Warfare. Chapter 10.The Virtual Naval Hospital: Available at www..vnh.org\/MedAspChemBioWar\/chapters\/chapter_10.hrm. Accessed 22 February 2004."},{"key":"S1049023X00015910_ref001","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.114315"},{"key":"S1049023X00015910_ref003","unstructured":"3Anonymous: National terror alert:Terrorism survival guide\u2014Facts about cyanide. Available at: http:\/\/www.nationalterroralert.com\/readyguide\/cyanide.htm. Accessed 26 January 2004."},{"key":"S1049023X00015910_ref002","first-page":"1","article-title":"Biological and chemical terrorism: strategic plan for preparedness and response","volume":"49","author":"Khan","year":"2000","journal-title":"MMWR"},{"key":"S1049023X00015910_ref019","first-page":"64","article-title":"Cyanide: The deadly terror weapon that every EMS provider must know about","volume":"24","author":"De Lorenzo","year":"1999","journal-title":"JEMS"},{"key":"S1049023X00015910_ref007","unstructured":"7Chemical Casualty Care Division, Aberdeen Proving Ground, MD. Cyanide AC, CK. United States Army Medical Research Institute of Chemical Defense: Medical Management of Chemical Casualties Handbook, 3rd edition. The Virtual Naval Hospital Project, 1997-2004. Available at http:\/\/www.vnh.org\/CHEMCASU\/03Cyanide.html. Accessed 13 January 2004."},{"key":"S1049023X00015910_ref018","doi-asserted-by":"publisher","DOI":"10.1007\/BF00353235"},{"key":"S1049023X00015910_ref017","first-page":"3","article-title":"Suspected cyanide poisoning in smoke inhalation: Complications of sodium nitrite therapy","volume":"9","author":"Hall","year":"1989","journal-title":"Journal de Toxicologie Clinique et Exp\u00e9rimentale"},{"key":"S1049023X00015910_ref016","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(86)80131-7"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X00015910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,2]],"date-time":"2019-05-02T16:26:54Z","timestamp":1556814414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X00015910\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,4]]},"references-count":21,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2006,4]]}},"alternative-id":["S1049023X00015910"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x00015910","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,4]]}}}